Stub Trine, Quandt Sara A, Arcury Thomas A, Sandberg Joanne C, Kristoffersen Agnete E, Musial Frauke, Salamonsen Anita
Department of Epidemiology and Prevention, Wake Forest School of Medicine, Division of Public Health Sciences, Winston-Salem, NC, 27157, USA.
Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
BMC Complement Altern Med. 2016 Sep 8;16(1):353. doi: 10.1186/s12906-016-1326-3.
Communication between different health care providers (conventional and complementary) and cancer patients about their use of complementary therapies affects the health and safety of the patients. The aim of this study was to examine the qualitative research literature on the perception of and communication about the risk of complementary therapies between different health care providers and cancer patients.
Systematic searches in six medical databases covering literature from 2000 to 2015 were performed. The studies were accessed according to the level of evidence and summarized into different risk situations. Qualitative content analysis was used to analyze the text data, and the codes were defined before and during the data analysis.
Twenty-nine papers were included in the primary analysis and five main themes were identified and discussed. The main risk situations identified were 1. Differences in treatment concepts and philosophical values among complementary and conventional health care providers. 2. Adverse effects from complementary products and herbs due to their contamination/toxicity and interactions with conventional cancer treatment. 3. Health care physicians and oncologists find it difficult to recommend many complementary modalities due to the lack of scientific evidence for their effect. 4. Lack of knowledge and information about complementary and conventional cancer treatments among different health care providers.
The risk of consuming herbs and products containing high level of toxins is a considerable threat to patient safety (direct risk). At the same time, the lack of scientific evidence of effect for many complementary therapies and differences in treatment philosophy among complementary and conventional health care providers potentially hinder effective communication about these threats with mutual patients (indirect risk). As such, indirect risk may pose an additional risk to patients who want to combine complementary therapies with conventional treatment in cancer care. Health care providers who care for cancer patients should be aware of these risks.
不同医疗服务提供者（传统和补充替代医学领域）与癌症患者之间就补充替代疗法的使用进行沟通，会影响患者的健康与安全。本研究旨在审查关于不同医疗服务提供者与癌症患者对补充替代疗法风险的认知及相关沟通情况的定性研究文献。
在六个医学数据库中进行系统检索，涵盖2000年至2015年的文献。根据证据水平获取研究，并归纳为不同的风险情况。采用定性内容分析法分析文本数据，在数据分析之前及过程中定义编码。
29篇论文纳入初步分析，确定并讨论了五个主要主题。确定的主要风险情况为：1. 补充替代医学与传统医疗服务提供者在治疗理念和哲学价值观上存在差异。2. 补充替代产品和草药因污染/毒性以及与传统癌症治疗的相互作用而产生不良反应。3. 由于缺乏科学证据证明其效果，医护人员和肿瘤学家难以推荐多种补充替代疗法。4. 不同医疗服务提供者对补充替代和传统癌症治疗缺乏知识和信息。
食用含有高毒素的草药和产品的风险对患者安全构成相当大的威胁（直接风险）。同时，许多补充替代疗法缺乏科学有效的证据，以及补充替代医学与传统医疗服务提供者在治疗理念上的差异，可能会妨碍与共同的患者就这些威胁进行有效沟通（间接风险）。因此，间接风险可能会给希望在癌症治疗中将补充替代疗法与传统治疗相结合的患者带来额外风险。照顾癌症患者的医疗服务提供者应意识到这些风险。
